{
"description": "This profile represents the constraints applied to the Immunization resource by the PS-CA project to represent a record of immunization in the patient summary. It is informed by the constraints of the [Immunization IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Immunization-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-immunization.html) to allow for cross-border and cross-jurisdiction sharing of Medication Summary information. It describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party.",
"_filename": "structuredefinition-profile-immunization-ca-ps.json",
"package_name": "ca.infoway.io.psca",
"date": "2024-04-09T00:00:00-08:00",
"derivation": "constraint",
"publisher": null,
"fhirVersion": "4.0.1",
"name": "ImmunizationPSCA",
"abstract": false,
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"type": "Immunization",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "Immunization (PS-CA)",
"package_version": "2.0.0-DFT-Ballot",
"status": "draft",
"id": "a943117a-4924-48c7-b858-9c52d9c9c55e",
"kind": "resource",
"url": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/immunization-ca-ps",
"version": null,
"differential": {
"element": [ {
"id": "Immunization.status",
"path": "Immunization.status",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode",
"path": "Immunization.vaccineCode",
"short": "Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided.\n\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code.\n\nOther coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product.",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/vaccineadministeredtradenamecode",
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "preferred"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/vaccinehistoricalnamecode"
}, {
"url": "documentation",
"valueMarkdown": "Equivalently recommended for use when conveying vaccine generic names for scenarios when brand name is not known or does not exist (e.g., immunization history where provider does not have detail of the trade name, the product has been discontinued and/or never licensed in Canada)."
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "preferred"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/passiveadministeredimmunizingagentcode"
}, {
"url": "documentation",
"valueMarkdown": "Equivalently recommended for use when conveying when passive immunization products are used."
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "preferred"
}, {
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/passivehistoricalimmunizingagentcode"
}, {
"url": "documentation",
"valueMarkdown": "Equivalently recommended for use when conveying when passive immunization products are used."
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/vaccines-snomed-ct-ips-free-set"
}, {
"url": "documentation",
"valueMarkdown": "Code for a vaccine that is selected from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set)."
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"
}, {
"url": "documentation",
"valueMarkdown": "Code that is selected from the WHO ATC classification."
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips"
}, {
"url": "documentation",
"valueMarkdown": "Code to identify absent or unknown immunizations."
} ]
} ],
"description": "Codes from the National Vaccine Catalogue Vaccine Administered Trade Name Code ValueSet. Equivalently preferred to the Vaccine Historical Name Code ValueSet, Passive Administered Immunizing Agent Code ValueSet, or Passive Historical Immunizing Agent Code ValueSet found in additionalBinding extension"
},
"comment": "See additionalBinding extension.\r\n\r\n Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content.\n\nIPS-UV Note: Several kinds of vaccine product coding could be provided.\n\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown.\n\nOther coded information can be provided as well as:\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 1, [Substance(s)]. Example: Amoxicillin and Clavulanate Potassium; or any other equivalent coded concept.\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 2 [Substance(s) + Strength + reference strength]. Example: Amoxicillin 875 mg and Clavulanate Potassium 125 mg; or any other equivalent coded concept.\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 3 [Substance(s) + administrable dose form]. Example: Amoxicillin and Clavulanate Potassium, Oral Tablet; or any other equivalent coded concept.\n 1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 4 [Substance(s) + strength + reference strength + administrable dose form]. Example: Amoxicillin 875 mg and clavulanate potassium 125 mg, oral tablet; or any other equivalent coded concept.\n 1. The IDMP Medicinal Product Identifier (MPID) or any equivalent Medicinal Product Identifier. IDMP MPID uniquely identifies a Medicinal Product, reflecting (but not replacing) any other authorization numbers allocated by a regulator. MPID implies one (set of) PhPID. The MPID shall use a common segment pattern related to a Medicinal Product, which, when each segment is valued shall define a specific MPID concept.\n 1. The IDMP Packaged Medicinal Product Identifier (PCID) or any equivalent Packaged Medicinal Product Identifier. Uniquely identifies a Medicinal Product based on its packaging. This implies one MPID can be associated with more than one PCID, if the same Medicinal Product has more than one type of package.\n 1. Any other kind of code that that identifies, classifies or clusters the administered product (e.g. the medicinal product or the product class).\n\nThe value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available.",
"definition": "Vaccine that was administered or was to be administered.",
"mustSupport": true
}, {
"id": "Immunization.patient",
"path": "Immunization.patient",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" ]
} ],
"mustSupport": true
}, {
"id": "Immunization.patient.reference",
"min": 1,
"path": "Immunization.patient.reference",
"mustSupport": true
}, {
"id": "Immunization.occurrence[x]",
"max": "1",
"min": 1,
"path": "Immunization.occurrence[x]",
"mustSupport": true
}, {
"id": "Immunization.occurrence[x].extension",
"path": "Immunization.occurrence[x].extension",
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "Immunization.occurrence[x].extension:data-absent-reason",
"max": "1",
"path": "Immunization.occurrence[x].extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
} ],
"short": "occurrence[x] absence reason",
"sliceName": "data-absent-reason",
"definition": "Provides a reason why the occurrence is missing.",
"mustSupport": true
}, {
"id": "Immunization.site",
"path": "Immunization.site",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"comment": "The development of a FHIR ValueSet & Terminology Gateway subset for this element is underway. Given that the migration of terminology from the CVC to NVC is underway, and that this element is no longer MS in PS-CA or IPS, the profiling on this binding has been temporarily removed and will be reapplied in future updates once there is an established subset to point to."
}, {
"id": "Immunization.route",
"path": "Immunization.route",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/immunizationrouteofadministrationcode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ImmunizationRoute"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration"
}, {
"url": "documentation",
"valueMarkdown": "Route of immunization administration includes content from EDQM Standard Terms."
} ]
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://terminology.hl7.org/ValueSet/v3-RouteOfAdministration"
}, {
"url": "documentation",
"valueMarkdown": "The path the administered medication takes to get into the body or into contact with the body. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
} ]
} ]
},
"comment": "See additionalBinding extension.\r\n\r\n IPS-UV no longer flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today.\n\nSystems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received.\n\nFuture releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received."
}, {
"id": "Immunization.protocolApplied.targetDisease",
"path": "Immunization.protocolApplied.targetDisease",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/vaccinepreventablediseasecode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ImmunizationRoute"
}, {
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
"extension": [ {
"url": "purpose",
"valueCode": "candidate"
}, {
"url": "valueSet",
"valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/target-diseases-snomed-ct-ips-free-set"
}, {
"url": "documentation",
"valueMarkdown": "Code for a disease the vaccination is against from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set)."
} ]
} ]
},
"comment": "See additionalBinding extension.\r\n\r\n IPS-UV no longer flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today.\n\nSystems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received."
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization"
}